Why Can't You Make the Lenses Stronger?

This is a question that is often asked by patients, or by the family of patients, who are suffering with AMD (Age-related Macular Degeneration). AMD affects the part of the eye that deals with detail and close-up vision. So very often, poor reading vision is a symptom of this condition.

Now, when they are younger, most patients will have traditionally had problems with reading vision corrected by a change in their reading glasses prescription. We just give the prescription a “tweak” or “make it a bit stronger” and hey presto! You can read clearly again. This is because the lenses in your reading glasses are correcting a condition called presbyopia (literally “Old Eyes”), where the lens in your eye loses some of its flexibility over time, and is unable to focus light on to the retina. The part of your eye that contains all of the cells makes sense of the images coming in. It’s a bit like the film in a camera.

Your retina is made up of lots of very clever, light-sensitive cells that help give depth, colour and detail to the images thrown at them. In particular, there is a large collection of cells in the middle of the retina called the macular and this is the area that deals with detail and, crucially, reading vision.

This part of the eye requires lots and lots of healthy vitamin production within the body to stay healthy and unfortunately, as we get older, our bodies ability to produce healthy vitamins decreases. This in turn can have a degenerative effect on those light sensitive cells in the macular, hence the name Aged-related Macular Degeneration. Unfortunately, any damage done cannot be undone (although it can be slowed down).

As we said earlier, the macular is like the film in a camera. And just like the film in a camera, regardless of how strong the lens is (in this case, the lenses in your reading glasses), if it’s damaged you cannot get a good quality image. Macular Degeneration puts a limit on how much improvement is possible through spectacle lenses, and that is why you can’t just make the lenses “a bit stronger”.